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Renal sympathetic denervation: effect on ambulatory blood pressure and blood pressure variability in patients with treatment-resistant hypertension. The ReShape CV-risk study

Journal of Human Hypertension volume 30, pages 153–157 (2016)Cite this article

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Abstract

Renal sympathetic denervation (RDN) represents a potential treatment option for highly selected patients with resistant arterial hypertension. In this open label study, we aimed to investigate the response of blood pressure (BP) and short-term BP variability (BPV) to RDN 6 months after procedure. We defined treatment-resistant hypertension as office systolic BP>140 mm Hg, despite maximum tolerated doses of ⩾4 antihypertensive drugs, including a diuretic. In addition, daytime systolic ambulatory blood pressure (ABPM) >135 mm Hg was required after witnessed intake of antihypertensive drugs. Bilateral RDN was performed with the Symplicity Catheter System (n=23). The mean systolic office BP and ABPM fell from 162±20 mm Hg to 139±19 mm Hg (P<0.001) and from 154±20 mm Hg to 144±16 mm Hg (P<0.038), respectively. In addition, we observed a significant reduction in diastolic office BP and ABPM. The current study also demonstrated a significant decrease of both systolic and diastolic average real variability, weighted standard deviation (s.d.) as well as conventional s.d. of mean and daytime BP, but not of s.d. of nighttime BP. RDN after witnessed intake of ⩾4 antihypertensive drugs reduced both office BP and ABPM at 6 months in patients with truly resistant hypertension. Also BPV improved, possibly reflecting an additional effect from intervening on the sympathetic nerve system.

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Acknowledgements

All authors are funded by governmental non-profit organizations in Norway. AM, ES and MS are funded by The North Norwegian Health authorities, TKS and IT by UiT The Arctic University of Norway. Laboratory services were provided by the Division of Diagnostic Services at the University Hospital of North Norway. The study was supported by grants from The North Norwegian Health authorities. We also received an unrestricted grant from Medtronic Company. The sponsors had no access to the study data and had no role in the design, conduct, or reporting of the study. Sources of funding: We thank all the participating patients and the study staff.

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  1. I Toft: Deceased.

Authors and Affiliations

  1. Department of Cardiology, University Hospital of North Norway, Tromsø, Norway

    A Miroslawska, E Skjølsvik & T K Steigen

  2. Department of Nephrology, University Hospital of North Norway, Tromsø, Norway

    M Solbu & I Toft

  3. Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway

    T K Steigen

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  1. A Miroslawska
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Correspondence to T K Steigen.

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Miroslawska, A., Solbu, M., Skjølsvik, E. et al. Renal sympathetic denervation: effect on ambulatory blood pressure and blood pressure variability in patients with treatment-resistant hypertension. The ReShape CV-risk study. J Hum Hypertens 30, 153–157 (2016). https://doi.org/10.1038/jhh.2015.69

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